As a child did you ever want to play with children of another sex? As
a girl, did you not want to grow breasts or menstruate? Did you
dislike girly clothing? As a boy, did you not like some of the
stereotypical boys toys, games or activities? Did you not want to
play so rough during aggressive games? Any one of these experiences
is a marker currently used to identify a person with gender identity
disorder. How many of us can honestly deny all of these experiences?
Gender Identity Disorder is the label used to pathologize more than
just transgender people. Most people do not fit in these rigid and
stereotypical gender categories. The current edition of the
Diagnostic and Statistical Manual (the DSM-IV text revision) uses a
mental disease label, Gender Identity Disorder, to classify people who
do not fit into the two narrowly defined gender=sex* roles. Now you
might be thinking, I am not a transexual or I am a “normal” person
this does not apply to me, but it does. Unless you have never been
teased for being too girly or too manish, unless you have never had
difficulty understanding how to fit in with all the other boys or
girls, unless you have never felt awkward in your body and unsure how
to be yourself this applies to you.
The good news is that gender expression does not have to be considered
a disease! In fact, variety and diversity should be encouraged.
Unfortunately the new edition of the Diagnostic and Statistical Manual
(the DSM-V, due out in 2013) still lists Gender Identity Disorder as a
psychiatric disease. The great news is that you can effect the way
doctors, therapists, and everyone looks at the way we all experience
gender. The American Psychiatric Association is reworking the
definition of Gender Identity Disorder for the DSM-V. We have five
days, until next Tuesday, April 20th to give our input on the
definition of Gender Identity Disorder. This decision is crucial to
the future of mental health and the way we treat people with diverse
genders.
It is important that all of us demand a change in the upcoming edition
of the DSM. When the DSM no longer categorizes people with
varied gender experiences and expression then doctors, social workers,
psychologists, psychiatrists and counselors can no longer use the DSM
to justify gender identity discrimination.
Right now there are only two ways to be considered a healthy human: a
feminine female or a masculine male. Most people cannot be the ideal
man or woman we are taught to be. Women are taught that they can
never be too thin or too youthful looking. Men are taught that they
can never be too rich or too strong. How many of you have felt at one
time, or maybe many times, that you were not man enough or woman
enough? As one University of Southern Maine student so simply put it,
“both of the gender ideals are unachieveable.” But if both of the
gender ideals are impossible then are the rest of insane?
In the past, being gay or lesbian was considered a mental health
diagnosis by the DSM. Homosexuality was removed from the third
edition of the DSM only to have Gender Identity Disorder inserted into
the fourth edition. Why does the American Psychiatric Association
feel the need to pathologize diversity?
When the DSM-III was published most Americans did not understand what
we understand now, that there are a variety of healthy sexual
orientations, including both gay and straight. When we look back at
the DSM-V will we regret not speaking up for supporting diverse and
healthy gender expressions? I know I will not.
To tell the APA to stop pathologizing people who do not fit within the
narrow gender norms go to http://www.dsm5.org/Pages/default.aspx to
post your comments.
If you would like to write to the APA about removing Gender Identity
Disorder from the upcoming edition of the DSM but are unsure what to
say feel free to cut and paste this message:
I support gender diversity. I do not support discrimination. Please
remove Gender Identity Disorder from the DSM-V. Thank you.
*See the previous blog for an explanation of difference between sex and gender.
All posts on this blog can be confidential. Rather than using your real name you can use any name, any handle, you want in the name field.
Beverly– I just got your email about changing the DSM — and I think (or hope) that in principle most people agree– gender =not a pathology. But interestingly one of the presenters at the TransForming Healthcare conference discussed this issue a bit, saying that if it were taken from the DSM many transgender people would no longer be able to receive mental health treatment services because the service wouldn’t be billable anymore. I’m interested in your thoughts on this. Do you think it’s important for people to be able to receive counseling services specific to gender identity? If so how could we manage a way for people to access this without pathologizing it? We know that there are specific needs for LGBT youth and adults to have peer supports in a structured environment (s/a Outright & PRYSM drop-in) but their funding is ever-shaky. Perhaps this is a bigger question about pathology too? Like why do you have to say I’m sick in order for me to be well? Why can’t I be well and continue being well by accessing the supports I see as meaningful in my wellness…. I hope what I’ve said isn’t very divisive– it’s not meant to be –Just that I’m very curious about how this kind of thing can play out for the best here and thinking about different perspectives.